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使用生物活性Cerecyte弹簧圈对颅内动脉瘤进行血管内治疗:对治疗稳定性的影响

Endovascular treatment of intracranial aneurysms with bioactive Cerecyte coils: effects on treatment stability.

作者信息

Geyik Serdar, Yavuz Kivilcim, Ergun Onur, Koc Osman, Cekirge Saruhan, Saatci Isil

机构信息

Department of Radiology, Hacettepe University Hospitals, Ankara, Turkey.

出版信息

Neuroradiology. 2008 Sep;50(9):787-93. doi: 10.1007/s00234-008-0399-1. Epub 2008 May 16.

Abstract

INTRODUCTION

The Cerecyte coils were developed to improve long-term stability of embolized cerebral aneurysms by producing an increased fibrous reaction over the neck of the aneurysms. We report our preliminary clinical experience with mid-term follow-up.

MATERIALS AND METHODS

Seventy-eight consecutive patients with 84 intracranial aneurysms treated exclusively with Cerecyte coils were included in this study. Forty-eight aneurysms were ruptured and 36 were incidental. Twenty-two aneurysms were small with (<10 mm) small neck (<4 mm) (SASN); 55 were small with wide neck (>or=4 mm) (SAWN); six were large (10-25 mm) (L); and one was giant (G) (>25 mm). The embolization technique was the same with that in standard bare coiling.

RESULTS

Immediate post-procedure angiography demonstrated complete aneurysm occlusion in 69%, neck remnant in 29.8% and incomplete occlusion in 1.2%. Follow-up angiography was obtained in 80 aneurysms in a period of time ranging from 6 months to 2 years. The overall recanalization rate was 11.3%, and the re-treatment rate was 6.3%; in the subgroup analysis, recanalization rates were 4.5% in S/S; 9.8% in S/W; and 33.3% in large aneurysms. The only giant aneurysm also showed recanalization. Procedure-related morbidity and mortality rates were 2.6% and 1.3%, respectively.

CONCLUSIONS

Our midterm results showed a relatively low rate of recurrence compared to those reported for platinum coils with morbidity and mortality rates comparable to those with standard bare platinum coils. The efficacy of Cerecyte coils in the long term will be specifically addressed by the ongoing randomized Cerecyte coil trial.

摘要

引言

研发Cerecyte弹簧圈是为了通过在动脉瘤颈部产生更强的纤维反应来提高栓塞脑动脉瘤的长期稳定性。我们报告中期随访的初步临床经验。

材料与方法

本研究纳入了连续78例仅用Cerecyte弹簧圈治疗84个颅内动脉瘤的患者。48个动脉瘤为破裂型,36个为偶然发现型。22个动脉瘤为小动脉瘤(<10 mm)且颈部小(<4 mm)(SASN);55个为小动脉瘤且颈部宽(≥4 mm)(SAWN);6个为大动脉瘤(10 - 25 mm)(L);1个为巨大动脉瘤(G)(>25 mm)。栓塞技术与标准裸弹簧圈栓塞相同。

结果

术后即刻血管造影显示动脉瘤完全闭塞率为69%,颈部残留率为29.8%,不完全闭塞率为1.2%。在6个月至2年的时间段内,对80个动脉瘤进行了随访血管造影。总体再通率为11.3%,再治疗率为6.3%;亚组分析显示,SASN的再通率为4.5%;SAWN的再通率为9.8%;大动脉瘤的再通率为33.3%。唯一的巨大动脉瘤也出现了再通。与手术相关的发病率和死亡率分别为2.6%和1.3%。

结论

我们的中期结果显示,与铂弹簧圈相比,复发率相对较低,发病率和死亡率与标准裸铂弹簧圈相当。正在进行的Cerecyte弹簧圈随机试验将专门探讨Cerecyte弹簧圈的长期疗效。

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